Category Archives: Thankful Thursday

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The groundhog saw his shadow today. Frankly, I didn’t need Punxsutawney Phil to tell me anything — the flamingos have been doing a pretty good job of letting us know what’s up around here, and it isn’t the temperature!

The Scout had his MRI last week and we’re still waiting for the results. (SuperDad has put a call in to the doctor.) Honestly, I’ll be surprised if it tells us anything at all. I have to keep reminding myself that he had a really horrid fall and it’s going to take more time to recover. It was encouraging last week to hear his teachers tell of seeing “more of him” lately, that more often now when he is in class he is managing to have that light on behind his eyes instead of a glazed-over look.

After a weekend of low stress and winter camping — where he felt relatively good and hardly needed extra rest time at all — he figured out that the anxiety over trying to accomplish all of his schoolwork is stressing his system. So on Monday when he went to school, The Scout met with his guidance counselor (the same one who helped us get the 504 Accommodation Plan set in place) and requested that he be allowed to drop two of his classes — Spanish 2 and Calculus. Bless her, she worked to make that happen. He has been able to attend school every day this week because he has some built-in “down time” where he can catch up on assignments or take a break in a quiet alcove or even take a nap in the nurse’s office.

Having my teenager engage in conversation with us is a blessing that I cannot take for granted. When the pain in his head (which he describes as “a hot iron pressing against my skull”) subsides enough to let him be his normal cheerful self, with a sense of humor and light in his eyes, I know how lucky we are.

I’m not really sure what to call the past 2 weeks. At times it has been joyous, but it has also been challenging in an unpleasant way. But first, the good stuff:

I’ve gotten to visit the next generation family twice over a 4-day window. I visited on a Saturday nearly 2 weeks ago . While The Scout and SuperDad were off Riding the Hiawatha, I had the privilege of riding with my little buddy. It had been 6 weeks since my last visit and I felt about three weeks overdue for grandson snuggles.

I cannot get enough of this sweet boy. SuperDad hadn’t seen him in person since Mother’s Day, so the two of us drove to their town again last Wednesday. I love seeing my husband being a grandpa.

Listening to Daddy’s voice coming out of the tube at the park… It’s so fun to see Little Foot clearly working his brain to figure out his world.

We were chillin’ at the park (literally, we were keeping cool at the end of a hot day). The Author, who loves all birds and had at one time wanted to become a veterinarian specializing in bird care, enjoys feeding the ducks. And then she caught one!

Little Foot was curious at first but then became jealous of the creature in Mommy’s arms where he rightfully belonged. It was clearly bedtime for baby.

Little Foot is 7 months old today. Time is passing by so quickly and his babyhood is already slipping away. His mama sent me this picture just a few days ago — Standing!

So now, let’s discuss the other young member of the family, our resident teenager, who has had a couple of painful lessons in life in the past month. As you might have read in yesterday’s post, he had his bicycle stolen a few weeks ago. I have sympathy for his plight; at the same time, I had mentioned a time or three that leaving the bike overnight at the school was unwise because a single bike in a deserted area was an invitation for thieves. Granted, the bike was stolen in broad daylight, but the school grounds were empty which is the same premise. So, bike gone, lesson learned. (I hope.)
Wait, did I use the word LESSON? Ah… this was the school year of taking an online Spanish course. The Scout struggled through this course, not really understanding much of anything. He’s our last kid and we are pretty hands-off at this point because he has been so responsible. What we didn’t know was that this was a “homegrown” course for the school district and by the end of the year, a majority of the students had dropped it, were failing it or in danger of failing it. We turned to a neighbor for help — he had taught high school Spanish before he retired — but even he couldn’t understand what the English directions were asking the students to do. With the neighbor’s help, The Scout took a “pass” on the course, scraping by with a D-. Now he is trying to catch up with students who took Spanish 1 in the classroom by taking a 6-week remedial course online for summer school. Unfortunately, this course began one day before said teenager left for a week of scout camp and will end with another week of scout camp , leaving him 4 weeks to do the work. There’s a strong chance he may end up repeating the course in a classroom in September. So that’s painful lesson #2.

The Scout went off to Rendezvous with minimal supplies. Many items were strictly forbidden due to the fact that they hadn’t yet been invented and/or in use during fur trapping 1830 North America. The boys waded to an island with their burlap sacks, built and slept in tepees, kept mosquitoes away with smoke, swam with beavers, and generally did things that mothers shouldn’t know about. It’s the sort of week where scout safety is quietly set aside for realism. I’m pretty sure the district office allows this to operate on a don’t ask/don’t tell policy. Our young man learned some useful skills and had a wonderful time. After picking him up on Saturday, we drove home with the windows open.

hand-sewn hunting bag

powder horn & scout-made bullets

It wasn’t all mud and beaver dams and mosquitoes; they also did sewing and bead work, shot with black powder, and learned a lot of history.

Painful lesson #3: It hurts when you fall out of a tree. Sunday afternoon he took a walk through the park — and because he is a teenage boy, he saw a tree and decided to climb it. He was 23 feet in the air when the branch broke. He landed on his back, blacked out briefly from the pain, got up and walked home. Ice and pain pills got him through the evening. Amazingly, he did not hit his head or break anything. Or die. The CT scan was “normal.”

**
“Where all the women are strong, all the men are good-looking, and all the children are above average.” – Garrison Keillor

I have discovered something about myself over the past 30 years, that when the truly frightening events occur — when the kid falls 2+ stories and lands on his back, when that same kid chokes and has to be thoroughly suctioned when he’s 6 hours old, when another kid totals the car, or I hit a deer at 50 mph –all those times and more, I enter a state of calm that is almost frightening in itself. It may appear that I am lackadaisical or don’t have a true understanding of the situation. It’s quite the opposite; I understand all too well.

I’m pleased to report that over the past month I’ve finally gotten over that mental hump and accepted that I’ll always have a certain level of pain. I’m calling it an annoyance factor, and as long as I can keep it to the dull roar of annoyance — by keeping my mind busy with other things — I am able to mostly ignore the pain level. However, when the weather turns stormy or when we sink back into a cycle of cold & rainy days, my ability to ignore the messages being sent from my ankle to my brain is hampered.

I’ve been reading up on why I have more pain when the barometric pressure is lower and/or when it is raining and/or when it is cold. The science behind it is fascinating even though it doesn’t make me hurt any less. I asked my Primary Care Provider if there was something I could take to relieve the pain which would be non-addicting and not harm my kidneys or liver. Basically, I’m out of luck on that front. My PCP did sign the paperwork to extend my temporary handicapped parking placard for the car so I’m grateful for the ability to have that when needed. Some days are better than others.

Joining the local YMCA and using the therapy/exercise pool classes has been helpful. My ankle seems to really benefit from the gentle water pressure. I tried walking in the lazy river (one local branch of the Y has an indoor lazy river) but the current causes the water to whirlpool and eddy, and while I hope to someday benefit from the extra work it provides for my ankle muscles, at this stage of the game it only causes major pain. (It’s one o’clock in the morning; do you know where your Percocet is?) The learning curve is real, people.

I’m also still going to physical therapy on a weekly basis. It took 30 visits but I finally made it to “lacking zero” — also known as being able to flex my foot far enough to create a 90 degree angle with my leg; this is what most people would consider normal without any effort at all, but I have to work to get there and work even more to stay there. I was really stiff and feeling pain on Sunday and it had nothing to do with the weather, unless hot & sunny days can cause pain and stiffness. I don’t use them all the time but I continue to keep Ziploc gallon-sized bags of frozen peas at hand for times such as this.

I don’t need the cane in my own house although I’m still unsteady when I first get up in the morning, or when I’m stiff (see above) but I continue to use the cane in public; it keeps small children and hurrying adults from bumping into me and I need it to navigate flights of stairs and uneven walking surfaces. I do still need to work on not limping. The limp is a symptom of favoring my left ankle instead of making it work 100%. I know it’s a slippery slope from a limp to back and hip troubles but it’s so hard to remember to really focus on not limping, especially when I’m tired or hurting (or both).

Monday, June 13th will mark my 7-month breakiversary. I wish I had less swelling at the end of the day and of course I would prefer to not have any pain at all, but all things considered, I’m doing well, slowly ramping up activities and learning to live with my new normal.

So for today, I am thankful for frozen veggie ice packs, a cane with a padded handle, handicap parking placards, physical therapists, good water pressure in therapy pools, and pain medications to take when needed.

Three months ago today, I had surgery for my trimalleolar fracture (compound breakage/shattering of just about everything possible in my ankle joint). I had already spent over 11 days in pain with my left foot/ankle elevated in the effort to reduce the swelling so that the surgical team could go ahead an operate. When we met with the surgeon prior to surgery, he made sure we understood how serious the situation was: worst case scenario, I’d never walk again or severely crippled by arthritis in the ankle. I’m no athlete but I do enjoying hiking and camping, and just being able to walk, so I was pretty motivated to heal well.

Surgery itself was a 5-hour ordeal for which I was sedated and blissfully “sleeping” (best sleep I’d had in weeks!) and all of us — the surgeon, my husband and I — were pleased that all the repairs had been completed in a single event. Swelling problems could have prevented him from working on both sides of my ankle in a single day, but the easier repair was done and sewn up with no trouble, so he went to work on the more difficult portion as well. In the picture below, I’m sure you can tell which side was more complicated to repair!

This X-ray was taken on 25 Nov. 2015 while I was still knocked out for surgery. The last one taken (4 Feb. 2016) shows proper healing but I don’t have a copy of it.

When I was about a month post-surgery, I wanted to know what my recovery would look like and I couldn’t get answers from the doctor. While I understand that everyone is different, I wanted — needed — a timeline for healing. All I found was this blog post, from someone younger, who was at an ideal weight and fitness level prior to her trimalleolar fracture and whose injury resulted in less hardware. While her milestones have been very helpful, I did not have the exact same experiences, so my purpose in posting today is to share what it has been like for me thus far for anyone else with a trimalleolar fracture.

The injury

I slipped and fell on my clean, dry kitchen floor on Friday, November 13th. At first we went to the Urgent Care Clinic, in hopes that I’d just dislocated my left ankle. They took an X-ray, wrapped my ankle in gauze and ace bandage, and sent us to the ER. At the ER they shook their heads over the simple bandaging meant to merely stabilize my ankle on a bumpy car ride, took better X-rays, and — after 4 attempts — “reduced” my ankle back into place. That experience was equivalent to the worst labor pains I’d had over four childbirths, in part because I had just spent 3.5 hours without pain relief, and it was just beginning to kick in when they attempted reduction. Emergency surgery on a Friday night is neither wise nor desired when one has an impressive amount of swelling (definitely not made better by the repeated attempts at reduction) so I was sent home with a prescription for Percocet and instructions to call for an orthopaedic appointment on Monday.

Monday was spent riding the health care insurance merry-go-round (by my husband; I was on Percocet, thankyouverymuch) and finally getting an appointment for Wednesday morning… which didn’t happen because a windstorm of historical proportions whipped through our region on Tuesday night,knocking out power everywhere. (Our home was without power for 8 nights, but that’s another post.)

The other thing we did on Monday was borrow a wheelchair from a friend. This was how I was transported to appointments. For home use (hopping to the bathroom on one foot), I had an old walker from a yard sale. Thank God for that $3.50 impulse purchase!
We finally saw an orthopaedic surgeon on Thursday, nearly one week post-injury. He told us how serious of an injury I had and noted how badly swollen I still was, so surgery was scheduled for the following Wednesday, November 25th. In the meantime, I was to be on my back with my foot and ankle elevated higher than my heart and nose. An upturned laundry hamper with pillows for padding under my legs did the trick. I continued to take Percocet to take the edge off the constant pain.

Post-Surgery to Three Months

I spent one night in the hospital. In part, this was due to such an intensive surgery (5 hours, 2 major incisions – one of which was difficult to close) and we believe it was also decided to keep me there because of our situation at home: we had been without power for 8 nights and 8 days, and there were no promises of when it would be restored. As it happened, the lights came back on around seven o’clock that night, so when we made it home on Thanksgiving day, the house had warmed up to a cozy 68 degrees Fahrenheit. I was on intravenous Dilauded (hydromorphone) while in the hospital and it definitely does suppress a person’s ability to keep breathing while asleep. Hooray for CPAPs!
I was sent home with 2mg Dilauded tablets for pain. Staying on top of the pain was crucial; going too long between dosages would send the pain spiraling out of control, but the side effects of the narcotics were unpleasant.

For the next three weeks, I returned weekly to the doctor’s office for wound checks and to be wrapped up in a fresh cast/splint combination. At 13 days post-surgery, he removed the stitches from the side of the ankle with the simpler repair. He had hoped that both sides would be ready for stitch removal, but I still had significant swelling which worried him. It was another week before the surgical site had completely closed and the remaining stitches could be removed.

Some of that swelling was probably related to the 15 hours I spent out of the prescribed stranded turtle position(my name for it) when my husband drove us 80 miles to be at a different hospital for the birth of our first grandchild. Knowing now all of what was at stake in regard to wounds not closing properly, I understand why my surgeon was upset that I had disobeyed orders; at the same time, if given a chance to do it over, I would do it again — and he acknowledged that I had warned him in advance that I fully intended to do what I did. Still… no one likes to be chastised and if it hadn’t been for such an important event, we wouldn’t have done it. Open wounds can become infected, and this wound went right to the bone. Infection was a real danger.

At 3 weeks post surgery, with the wound finally closed and stitches removed, I was placed in a CAM boot but was told to put no weight on my foot whatsoever. Believe me, I had no desire to do so! With the closing of the wound and the blessing of the doctor, I could put my foot in a lower position, so I was able to “do” a few things: watch a movie in the living room recliner, attend my son’s band concert in a wheelchair, attend a Christmas party with my husband, and go to church. Those events wore me out physically but helped my mental and emotional state. At least I was no longer limited to visits to the bathroom and visits to the doctor!

I began physical therapy after my 6 week post-op visit. The doctor told me to start bearing weight in my CAM-booted foot as tolerated. He also told me I shouldn’t need the strong pain meds anymore. I’d already cut back quite a bit but now was time to go off them. He explained that it would take up to four days but that my body would begin making its own natural form of opioids once the pharmaceuticals cleared from my system. I’m not sure if that is true, but I wanted to move on. Five days later my system was clear and I was no longer taking pain meds (although I continue to take Tylenol and Ibuprofen for pain) and I began driving myself to PT when the roads were not icy. There are nights that I have trouble sleeping because of pain and/or spasms, but I like the freedom of driving so most nights I suffer until I can fall asleep. For the occasional truly miserable nights, when a cup of chamomile tea, a hot pad for my calf and a frozen bag of peas for my ankle doesn’t relax me or ease the pain enough to allow me to sleep, I take half of one of my remaining Percocet pills from before surgery — but that is always a last resort.

I had hoped the doctor would write a prescription (for insurance purposes) for me to get one of those cool knee scooters. Initially I wasn’t able to use one because of my issues with swelling and the need to keep my left foot elevated. However, once I was allowed to put a little weight on that foot in the CAM boot, he said he wanted me using that foot, not babying it, so I was stuck with using a walker for the month of January. It is a slow mode of transportation. Physical therapy has been very important in teaching me how to walk without limping or injuring my back with overcompensation.

At the beginning of February, one month after my 6-week post-op visit, I saw the doctor for what might be the final time (unless I have future problems with the ankle or the hardware). Fresh X-rays showed that my ankle has healed well and he told me “ditch the old lady walker” and resume life as normal. Easy for him to say! I found the concept of putting weight on my unprotected foot to be terribly frightening. The physical therapist has a much more measured approach. I am walking at home and at PT in bare feet with the walker, learning to put normal amounts of weight on that foot. The rest of the time I wear the CAM boot on my left foot, a hiking boot on my right foot, and use a 4-point cane for stability as needed — particularly for uneven surfaces, curbs, and stairs. I’m still slow but not as slow as I was a month ago when I could barely put any weight on my foot at all. There are times now that I am barefoot in my house and I use the walker to get across the room, then forget to use it to return. This is progress!

I went back to work at the beginning of February. I only work two days per week and spend a good part of the time sitting, or this would have been impossible. However, I still swell up easily and a weekend of babysitting my grandson — with the 90 minute drive each way, the lack of time spent elevating and icing, and the carrying of extra weight — while I was thrilled to spend time with him, I’m still battling painful swelling 4 days after coming home. If it doesn’t go down soon, I’ll be plunging my foot/ankle/leg into contrast baths: a bucket of ice water as long as I can bear it, then a bucket of warm bath water, then a bucket of ice water… Does that sound like fun? It’s my last resort but I may soon be trying it.

I decided to tag/categorize this post as Thankful Thursday because I am aware that, despite the pain and frustration which accompany me on this journey to healing, I am doing so much better than I was led to believe I would be doing. When I first injured my ankle, I thought it would be about 6 weeks before I would be walking again. Denial, much? And yet, when I first met with the surgeon, he warned me that I might never walk again or that I might have crippling arthritis. It’s true that I am regularly hovering at 3-to-4 on my personal pain scale (between 3-and-5 on the scale with bees) and that I often reach 6-to-7 during physical therapy or at the end of a busy day; however, there is an awful lot of hardware inside my ankle. My left ankle is a full inch larger in circumference than my right ankle at this point in time. I hope that is due mostly to swelling and that I don’t continue to rock that steroid look, but I would much rather have a fat ankle than not walk at all. I returned to work ten weeks after surgery and prior to that I was working from home on my laptop. I’m walking in a CAM boot away from home and walking barefoot with ready support at home. That’s a lot of progress! It’s important for me to continually remind myself that I’ve come a long way since injury.

If you’d like to read all of my post-injury blog posts in order, you can start with this one and move forward chronologically. I’ve also put all of my “journey to healing” posts under that category, so you could use that term to search for the posts that way. (There’s a search engine and category cloud on the sidebar to the right.)

First, there was the near-total destruction of my left ankle. The doctor said I broke every bone possible, and then some…

CT Scan of my broken left ankle

Then there was the record-breaking windstorm that swept through my town and took out our power for 8 long nights and days.

A house a few blocks away from my own home. This one is a total loss.

And then it snowed…

I am so grateful to have a gas-powered hot water heater (we had hot showers!) and a gas stove cooktop, and a wood stove. It was still cold in my bedroom but the main part of the house was almost pleasantly warm and my live-in nurse brought me tea each morning.

This is how I slept in my chilly 48° (9°C) bedroom. I had to keep my ankle elevated higher than my heart or my nose, and I didn’t want to bump it at all — it was still broken, still shattered, and being held still in a temporary cast — so I slept on top of the bed with additional blankets.

“Keep your hand at ankle abovethe level of your eyes nose.”

Keeping warm

Keeping elevated

Since we still had hot water — and trust me, I know how precious that was! — I was able to shower very carefully while in my temporary cast.[click on pics for captions]

Pay no attention to the woman behind the curtain…

Where the magic happens

Our power came back on while I was in the hospital post-surgery. SuperDad brought me home on Thanksgiving Day. Just a few minutes after settling me in, my in-laws came through the front door. They came to my room to visit with me and then they went back out to the kitchen and took over preparations for the big Thanksgiving meal.

So this is my life for the next few weeks: elevation and scheduled doses of pain medications. There’s quite a bit of hardware in that ankle:

There’s something about the beginning of the fall season makes me more intentional in my enjoyment of the weather. I am invigorated by the chilly air in the mornings; I revel in the cool evening air and am nearly gleeful when I feel the need to don a jacket. The leaves on the trees change color and drop to the ground like orange, yellow, brown, and red manna.

Along with being outside for my high school student’s cross-country meets, I’ve been making extra effort to go for walks. Soaking up sunshine on these beautiful fall days is something that my soul demands of me, even to the point that I become grouchy if I am indoors all day. Last Saturday, SuperDad invited me to go with him to the disc golf course (he plays, I walk along and take pictures). On Monday, we made a mid-day date of walking along a newly paved stretch of the Centennial Trail high above the river. We ate our picnic snack of cheese and crackers, talked about how much our old neighborhood had changed (this particular area was old railroad land 25 years ago) and then chose one of the new trendy restaurants with patio dining for the salad course.

I am outdoors for more than 5 hours each Friday for the farmers’ market. One of the new vendors is a craft brewery which had its grand opening on Tuesday afternoon. Since I knew this in advance, I went to work more than 90 minutes early on Tuesday so that I could leave a little early that afternoon. At 4:00 p.m., several of us walked the two blocks to enjoy a glass of beer together, sitting outside on the fenced-in patio as we talked and admired the work of the designer. (I also noted that I was in the presence of more hipsters than I had ever been before.)

Due to work, vending at the farmers’ market, and the times & dates of our “home” football games, I have not yet been able to see and hear our youngest play with the high school marching band. Nearly all of the games are played in a much-too-large (and aged) stadium shared by all of the teams in the league, so the designation between home team and visiting team is made by which side you are assigned to sit and whether or not you can bring your band. I have only one more chance next week to see SM perform and I’ll make a sincere effort to get out of work early to make that happen.

Putting up seasonal decorations makes me happy, and it’s something I haven’t been as timely about since I began working outside the home, but yesterday I managed to take down the spring/summer decor outside and replace it with more appropriate colors for autumn. A few more do-dads will come out of storage for the week of Halloween, but at least from the street it looks like I am aware it is no longer May.
The inside of the house will probably have to wait for a day I don’t want to be outside.